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Study Heralds Medicaid Expansion Benefits As Rural Hospitals Close

According to a study released by the Robert Wood Johnson Foundation, states that expanded Medicaid programs using federal funding are reaping economic benefit. As the never-ending healthcare debate rages on in the Tennessee legislature, Tennessee is among 19 states that have, thus far, declined to expand coverage to those who fall in the uninsured gap between qualifying for traditional Medicaid and being qualified to buy insurance on the federally run exchange.

According to the report, states like Arkansas and Kentucky each saw savings and gains in revenue since expanding their programs. The study looked at 11 states and Washington DC.  As rural hospitals around Tennessee and across the nation are closing down, Insure Tennessee, a tiered coverage insurance system using federal Medicaid expansion funding, was pitched to the state legislature in 2015. However, a partisan committee blocked the proposal. The state was sued by the Southern Poverty Law Center for depriving its citizens of Medicaid coverage in 2014.

Medicaid and Medicare Rules for Nursing Homes/Long Term Care

If you or a loved one requires long-term medical care, you will soon realize how expensive and difficult it is to come by. The average cost of nursing home care in Tennessee is around $6,000 per month. While many people assume that Medicare covers this cost, the reality is that the program only temporarily covers nursing home care.

Medicaid is a joint state and federal program that covers the costs of nursing homes and custodial care for people with low incomes/assets. It does not cover care in assisted living facilities. CHOICES, part of TennCare (Tennessee’s Medicaid program), is the major state-funded payer for nursing home care in Tennessee.

When a person applies for CHOICES, a caseworker from the Area Agency on Aging and Disability gathers information about the applicant’s medical needs and interviews them. In order to qualify for the program, the applicant must receive Social Security Insurance (SSI) payments. The financial bar to qualify is high. In general, one cannot have more than $2,199 in income per month and cannot have more than $2,000 in assets.

However, assets that are not counted toward this $2,000 limit include the applicant’s home, life insurance policies, a car, and tangible personal effects worth less than that amount. Those with more assets than that in the form of cash, savings, and investments are deemed ineligible for CHOICES.

Call a Nashville Insurance Dispute and Civil Litigation Lawyer Today

At the office of Calhoun Law, PLC in Nashville, we understand how stressful it is to ensure that a loved one gets the care they need. We are well versed in the complex world of medical insurance, insurance laws, and Social Security law since many of our lawyers have worked on behalf of insurance providers. In instances where you have been denied rightful coverage, we will carefully examine your case and aggressively pursue your legal claims. Contact us today for a free and confidential consultation.

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